Cell therapy of critical limb ischemia-problems and prospects

Vasa. 2019 Nov;48(6):461-471. doi: 10.1024/0301-1526/a000787. Epub 2019 Apr 10.

Abstract

Cell therapy is proposed for indirect revascularization for the patient's incurable by endovascular or surgical revascularization. The therapy with stem cells (SCs) or progenitor cells is assumed to be more efficient as compared with protein or gene therapy not only because of their direct vasculogenic properties, but also thanks to their paracrine effect via secretion of manifold biologically active substances. This review gives an overview of the potential of SC-based therapy for critical limb ischemia (CLI), putative mechanism underlying cell therapy, and comparison of cell therapy to angiogenesis gene therapy in CLI treatment. Human trial data and meta-analysis, as well as some problems of clinical trials and considerations for future SC-based therapy in CLI are also discussed.

Keywords: Angiogenesis; bone marrow stem cells; cell therapy; critical lower limb ischemia; peripheral vascular disease.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical
  • Cell- and Tissue-Based Therapy*
  • Critical Illness
  • Genetic Therapy
  • Humans
  • Ischemia* / therapy
  • Limb Salvage
  • Treatment Outcome
  • Vascular Surgical Procedures